Integrated Appointment Reminder System

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  • Sherwin Gaddis

    Sherwin Gaddis - 2013-07-31


    We are in the process of building an semi automated appointment reminder system for the EMR. We have laid most of the ground work and will start beta testing next week. I am putting this out today on the board for feedback. We have had a couple of users ask for this feature and wanted to get a feel for how receptive the community would be for an integrated call reminder.

    Since phone calls will be involved it will not be a free service it will be a paid subscription. We plan on building it semi automatic because in our thinking a click of the button just so you know it was done. We may code it to give the option of completely automatic. The dialing partner that we will be using will work in any country not just the US.

    Since it is just a call reminder system we have not thought of any features that would enhance the feature. Send me any of those that you may think of. We want to bring a few people on at a time before going into full production. So, any one wanting to be early adopters please contact me.



  • fsgl

    fsgl - 2013-08-01

    To remain on the safe side of HIPAA, would suggest that the patient's name not be mentioned in the automated call, in the event that the practice called the wrong telephone number. Repeating the office, time and day of the appointment will be helpful to seniors who are forgetful or not quick enough to grab pen and paper.

  • DrKay

    DrKay - 2013-08-01

    I think you have to give the patient's first name, otherwise families with multiple members (I have families with 5-6 children) won't know who the appointmnet is for. The University of California system gives patient's first names on automated reminder calls, as does Kaiser, and, I imagine, they've got some good lawyers who have looked at this.

  • Kevin Yeh

    Kevin Yeh - 2013-08-01

    Alfonso, thanks for that document. It is very helpful for understanding this and other issues.
    For this issue, page 6 as you note states.

    Q:May physician’s offices or pharmacists leave messages for patients at their homes, either on an answering machine or with a family member, to remind them of appointments or to inform them that a prescription is ready? May providers continue to mail appointment or prescription refill reminders to patients’ homes?
    A: Yes. The HIPAA Privacy Rule permits health care providers to communicate with patients regarding their health care. This includes communicating with patients at their homes, whether through the mail or by phone or in some other manner. In addition, the Rule does not prohibit covered entities from leaving messages for patients on their answering machines. However, to reasonably safeguard the individual’s privacy, covered entities should take care to limit the amount of information disclosed on the answering machine. For example, a covered entity might want to consider leaving only its name and number and other information necessary to confirm an appointment, or ask the individual to call back.
    A covered entity also may leave a message with a family member or other person who answers the phone when the patient is not home. The Privacy Rule permits covered entities to disclose limited information to family members, friends, or other persons regarding an individual’s care, even when the individual is not present. However, covered entities should use professional judgment to assure that such disclosures are in the best interest of the individual and limit the information disclosed. See 45 CFR 164.510(b)(3).
    In situations where a patient has requested that the covered entity communicate with him in a confidential manner, such as by alternative means or at an alternative location, the covered entity must accommodate that request, if reasonable. For example, the Department considers a request to receive mailings from the covered entity in a closed envelope rather than by postcard to be a reasonable request that should be accommodated. Similarly, a request to receive mail from the covered entity at a post office box rather than at home, or to receive calls at the office rather than at home are also considered to be reasonable requests, absent extenuating circumstances. See 45 CFR 164.522(b).

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-08-03

    Thank all of you for your feedback and input.

    We should be doing a full run test of the basic functions on Monday Aug 5th 2013.
    If all goes well then we have just the registration process to build out then release it for inclusion of others in the beta testing and continual build process.

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-08-06

    All is going well, I have updated the open-emr page to include this new function in the system. We have completed almost a week of call reminders and have worked out the bugs thus far.
    We are ready to add 2 - 5 beta testers. Please contact me to join the beta testing team.
    After the release of 4.1.2, we will post the code for the call back system.

    I will continue to post our progress. I will post a video on how it works by Aug 16th.

  • Brady Miller

    Brady Miller - 2013-08-07

    Hi Sherwin,

    Sounds great. I don't have much time to beta test but would like to glance through the code.

    Makes sense to use the
    to discuss the ongoing work, just make sure it's clear that it's under development and not yet available in OpenEMR Production versions yet (perhaps state it will end up in a 4.1.2 patch or 4.1.3 in the future).

    Another good place to track active projects is here:
    (In Developers section in Main section on the main wiki apge)

    Also the OpenEMR Feature page is only for stuff that is in the current production version (4.1.1). It will get updated to 4.1.2 after release. So wouldn't put any features there that do not exist in stock OpenEMR 4.1.1 .

    Still very glad to see the wiki being used for this stuff, so please keep making use of it (I'll let you know if any issues which are extremely easy to remedy; ie. would much rather mistakes happen than nothing happen).


  • David

    David - 2013-08-07

    Any idea what the cost will be for the service?

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-08-09

    Hi David,

    Sorry for the late post back. The cost will be 7.5₵ per minute. The longest call I have observed so far has taken 2 minutes to complete. Average call is 30 seconds. The total cost will depend on the practice patient volume. If a practice has 20 patients to contact, the cost will be ~$1.50 for that days calls and ~$30 for the month.

    We will be billing for exact usage so a practice will only pay for what it uses. The monthly billing will be done in arrears of service. There will be a setup fee of $75.

    We have a couple of more steps to automate, then we will be posting a patch on github.
    We are looking at Sept 1 a release to the community.

    Last edit: Sherwin Gaddis 2013-09-25
  • Kevin Yeh

    Kevin Yeh - 2013-08-15

    Those look like real names of some of Dr. Garris's patients.

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-08-15

    Those are all made up names in a dummy setup. I was trying to cut out but thanks for the catch Kevin.

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-08-30


    the base code is finished. We have had two weeks of successful runs with the integrations and it is ready for review. The code will be posted for review by Tuesday.

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-09-04


    The code is 99% functional. There is one small detail that needs to be resolved but there is a work around for it. We will be posting a link here for those that would like to register to download the code. We have started on tying in the clinical reminders. It should be ready in two to three weeks.

    The cost for the service is going to be a flat fee of $60/mo and will be adjusted if call volume exceeds costs.

    When we are done, the Clinical reminders will work in full where the system will be able to send SMS, Emails and do VOICE reminders.

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-09-10


    the code is ready for general use. It currently does voice reminders. The code is setup to have some interaction with the front desk or person put in charge of the call reminders.
    The code can be downloaded from

    This is how it is coded to work:

    The person in charge of the making the calls to the patient will click the Appt Reminder tab under Patient/Client.

    The system then goes to the calendar for the next day and collects all appointments and uploads them to be called one hour from the time that the button is clicked.

    The system then posts the results from the previous days calls.

    Once the calls have been made, a report is generated to display the results of the calls. The system displays the phone number that was called and the time of the call and result i.e. "Voice Mail" "No Reached" "Confirmed" "Canceled". There is a simple lookup to get the patient name that canceled. One can copy and past the number into the Patients screen that is under Patient/Client. We are waiting for the development team to be able to return the name and phone number together in the displayed report.

    We will be expanding the features of the feature as we gain support for this project through its adoption by the community. The system can work world wide. It is not just limited to the United States.

    We are working on doing the voice calls for the clinical reminders and we have our a target date of October 15th. We should have a functioning model by then.

    If there are any developer that adds to this code, please share it back with us.

    Please send feature request to me at

    Last edit: Sherwin Gaddis 2013-09-10
  • Brady Miller

    Brady Miller - 2013-09-10

    Hi Sherwin,

    Link above is broken. What branch is this code in? I'll do a quick rebase of your code into one commit and post it to github for review which is a far superior way for us to review the code (I know I was gonna show you how to do this via email, but I haven't had time to type out the instructions.)


    Last edit: Brady Miller 2013-09-10
  • Sherwin Gaddis

    Sherwin Gaddis - 2013-09-10


    to install the patch simply unzip it and copy the folders to the your instance of the program.

    Go to the SQL folder and import the call_reminders.sql and the reminder_content.sql.

    Next go to and submit the payment form.

    Once we receive your payment we will email you the IVR username and password.

    Once you receive those go to Administration > Globals > Notifications and check the box to activate the IVR and copy and paste the username and password that was sent. Program will be activated and ready for use as described above.

    Post any questions here:

  • Kevin Yeh

    Kevin Yeh - 2013-09-10

    Your link to the zip file results in:

    OpenEMR Appointment Reminder System
    Page not found
    The requested page "/pacs/" could not be found.

  • Sherwin Gaddis

    Sherwin Gaddis - 2013-09-10

    Kevin, I corrected the link.

  • Brady Miller

    Brady Miller - 2013-09-11


    I rebased Sherwin's commits into one commit (I also rebased it into the most current codebase) and placed here for review/testing:

    So, let the github review and testing commence :)

    Sherwin, you should grab this branch and begin working on it now, which can be done with the following in commandline git:
    git remote add brady git://
    git fetch brady
    git checkout brady/sherwin-appt-reminder-rebase_1
    (ignore the warning)
    git checkout -b appt-reminder-rebase_1
    (at this point you will now have a appt-reminder-rebase_1 branch with your commit on top of the most recent OpenEMR codebase)


    • Sherwin Gaddis

      Sherwin Gaddis - 2013-09-11


      when I run the first command I get:
      fatal: Not a git repository (or any of the parent directories): .git

      I am running the command from the Git Bash command line window.

      Thanks for your help

      • Brady Miller

        Brady Miller - 2013-09-12

        Hi Sherwin,

        You need to run these commands within your git repo, so guessing you need to do the following to go into your repo from git bash window:
        cd openemr-1


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